Provider Demographics
NPI:1952019036
Name:PERPETUAL VENTURES. LLC
Entity Type:Organization
Organization Name:PERPETUAL VENTURES. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-476-9030
Mailing Address - Street 1:9213 ARCHIBALD AVE
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-5207
Mailing Address - Country:US
Mailing Address - Phone:909-476-9030
Mailing Address - Fax:909-476-9130
Practice Address - Street 1:9213 ARCHIBALD AVE
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-5207
Practice Address - Country:US
Practice Address - Phone:909-476-9030
Practice Address - Fax:909-476-9130
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOME INSTEAD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA364700002OtherSTATE LICENSE